The Canadian National Dementia Strategy

Last week we presented an infographic to show you the impact of dementia on Canada. Thankfully,  on June 22, 2017, Bill C-233 received Royal Assent and became law in Canada. This law, “An Act respecting a national strategy for Alzheimer’s disease and other dementias” mandates that all provinces and territories across Canada work together to develop and implement a national dementia strategy that addresses 7 key areas. By mandating the implementation of this national dementia strategy, Canada has ensured that something actually gets done to support all people affected by dementia.

The seven key areas that must be addressed include:

  1. Develop national objectives to decreased suffering and reduce the burden of dementia on society;
  2. Encourage investment in all areas of research related to dementia;
  3. Working with other countries to combat dementia (because dementia is a global pandemic);
  4. Nation-wide development and dissemination of diagnostic and treatment best practices;
  5. Nation-wide dissemination of best practices on how to improve quality of life for people living with dementia and their caregivers achieved through care integration, chronic disease prevention and management, community services, and family supports;
  6. Supporting the development and dissemination of information on prevention, management, and early treatment; and
  7. Create recommendations and guidelines for best practices in care delivery and daily programming.

And it doesn’t stop there. By June 2019, and every year after that, the Minister of Health must give a report on how the National Dementia Strategy is doing along with any new recommendations.

Dementia pandemic

So what does all this mean to you?

It means that you and your family will be receiving better care and support. It means that we will start coordinating with other countries who are leading the way in dementia care (such as the Netherlands), and learn from how they have successfully, and not so successfully, supported their citizens who are affected by dementia. It means that we should be able to reduce the currently projected cost of dementia in dollars, but also in its cost to productivity and personal stress.

It means that Canada isn’t ignoring you. It means that Canada has realized that Alzheimer’s disease and other dementias cause a lot of pain and suffering. It means that Canada believes you shouldn’t go it alone.

With projections estimating a rapid increase in the number of people living with dementia and subsequent cost to Canadian society, it is imperative we launch a coordinated attack. In the end, this National Dementia Strategy will improve the quality of life of everyone affected by the disease.


Next steps: Funding. It’s all fine and dandy to design a fantastic dementia strategy, but we need funds to put it in place. However, the strategy isn’t finalized yet, so until then, we won’t know how much money we’ll need to implement it. Until then…

Advertisements

Am I Selfish?

By Eleanor Pineau

Family caregivers of someone with dementia have a tough job. These Heroes are essentially on-duty 24/7. They direct not only their own lives, but the life of the person with dementia…to an extent. They are in-charge of personal care (i.e., bathing, toileting, grooming, etc.), meals, socialization, finances, housing – anything that goes into “LIFE,” falls on the family caregiver.

Family caregivers often become overwhelmed and stressed out. And we all know what stress can do to us! Stress breakscaregiver us down from the inside out; it’s with us almost 100% of the time; it makes us eat; it makes us stop eating; it makes us sleep non-stop; it makes us stop sleeping; it makes us gain weight; it makes us get physically sick. Stress can be traced to the root of almost all physical ailments, and absolutely worsens any physical or psychological illness.

After all family caregivers do, I still get asked: “Am I selfish?”

Am I selfish if:

  • I want to take a bath?
  • I want to go to the gym?
  • I want to go on a vacation?
  • I want to see my friends?
  • I don’t want to do it anymore?

These questions, among others, are completely normal. So what’s the answer?

You. Are. Not. Selfish.

It’s completely normal to want to take a bath, go to the gym, go on vacation, see your friends, and take a step back from caregiving. It’s also completely normal and even HEALTHY to DO those things! Do th
em!

If you find fulfillment, or a sense of pride, duty or accomplishment in caregiving, then do it. But know that you also need to take care of yourself. Helping someone in their time of need is one of the greatest gifts yo
u can give that person, AND yourself. But you shouldn’t go into caregiving every day with dread or feeling dispirited. So how do you stop or prevent feeling this way?

Take. Care. Of. Yourself.

I know it’s easier said than done, but go take a bath, go to the gym, go on vacation, see your friends, and take a step back from caregiving.

There are many community resources that can help you along the Dementia Journey. Meal delivery services can save you time so you have more time for yourself. Respite care is great because you can be assured your loved one is safe and well-taken care of while you can go see friends, go to the gym, or go on that trip you’ve been longing for.

It is incredibly important to take care of yourself so that you can continue to care for your loved one, and so that you don’t feel your life is on hold. Your life is NOT on hold. You are growing, developing, learning, and changing every day. Though you may not feel it all the time, you are tackling and overcoming one of life’s greatest challenges. You Are Thriving. Stay strong and continue to thrive by balancing caregiving and self-care.

Because we NEED YOU.

Please share in the comments your tips and tricks for making the Dementia Journey a little easier so you can put time into self-care 🙂

Steps to Remember your Daughter

By Eleanor Pineau

We all know: Exercise is good for you. Go for a run. Take the Stairs. Lift some weights. Walk or bike, don’t drive.

But how important is exercise really? And how important is exercise to someone that has dementia?

If there was a magical pill for all of our aches and pains, it would be exercise. The number of things exercise prevents AND treats is, well, EVERYTHING. High blood pressure? Go exercise. Depressed? Go exercise. In pain? Go exercise. Afraid of getting dementia? Go. Exercise. Name a condition or symptom, and exercise is bound to have a positive impact on it.

A group of elderly people exercising together on balance balls

Exercise in older populations is incredibly important to maintain independence, dignity, and quality of life. It is also the most important intervention to prevent falls. This is extremely important as falls is a predictor of loss of independence and death. These factors remain applicable to persons with dementia.

People often think that once someone is diagnosed with dementia, that all is lost, and exercise is not needed. Because, well, “they’re not all there anymore.” Right?

Wrong.

Persons with dementia need to exercise. Oftentimes, these people are also quite capable of physical activity. They need to exercise in order to prevent falling, control other comorbidities/diseases like heart failure, osteoporosis, arthritis, high cholesterol levels, and so forth. They also need exercise in order to prevent depression, delirium, and to help them reduce any pain.

Another thing exercise helps with is drugs. Unfortunately, many people with a cognitive impairment like dementia, take multiple drugs. Taking too many drugs is very dangerous, especially in someone with dementia. Side effects or interactions between drugs are very likely, and these can cause heart attacks, accelerated cognitive decline, and even death. Exercise helps to fix the reason they are on a drug. For example, exercise helps with cholesterol levels so now they don’t need to be on that cholesterol medication.

Many people with dementia are put on anti-psychotics because they have sedative properties. These sedatives are used to sedate the person with dementia so that they no longer yell, wander, or show physical aggression – these are “problem/responsive behaviours” aka “personal expressions.” These drugs actually cause greater cognitive decline, and physical decline – so independence is reduced. In lieu to these drugs, we should be prescribing an exercise regime. Oftentimes, the reason why someone with dementia is yelling, wandering, or being physically aggressive, is because they are in pain, they’re agitated, they’re bored, or they need some physical stimulation. Well you guessed it, exercise cures these!

Exercise!

A lot of people look for a cure or for something that will slow the progression of dementia. And you guessed it again. So far, the only thing that holds promise to prevent or slow the progression of dementia is exercise! Exercising increases blood flow to the brain which increases nourishment and waste removal. It also enhances neurogenesis, or neuron growth! (So in dementia, neurons are constantly being destroyed, and this is why we see memory loss, poor judgement, poor communication, etc. But exercise stimulates the growth of neurons, and keeps neurons healthy which prevents their destruction!) So in essence, exercise slows the rate of dementia, which keeps the person happy and healthy for longer! They can remember more things throughout the day, they have better judgement, and they can find the words they’re looking for!

Exercise!

But where to start? You have a couple of options:

  1. Exercise at home on your own
  2. Attend a fitness class in the community
  3. Access personal training

 

  1. Exercising at home on your own

If you and your loved one prefer to exercise at home without any expert advice, you need to take into consideration a couple of key things. First, make sure that your loved one with dementia is wearing comfortable, proper-fitting shoes. This will reduce the risk of falling. Second, make sure your workout space is clear of debris and you’re in a well-lit room. Again, these will reduce the risk of falling. Third, make sure you use proper equipment and safety measures. For example, you should consult a personal trainer or physiotherapist to ensure that you aren’t doing any movements that are contraindicated by a medical condition. If you have osteoporosis, you should not be doing any twisting motions with your back. Consulting a personal trainer or physiotherapist will undoubtedly ensure your safety. Lastly, the most important thing is to have fun! So turn up your favourite music and get your body pumping!

  1. Attending a fitness class in the community

There are lots of exercise classes in the community. You can find them at gyms, churches, or senior centres. Unfortunately, most are not tailored to people with dementia. There is however one program – Minds in Motion – that is delivered by the Alzheimer Society. This exercise program is catered to persons with dementia. It runs once a week for 8 weeks in a community recreation centre. Participants engage in 45-60mins of physical activity, and 45-60mins of mentally stimulation activities.

To find out more, follow this link: http://www.alzheimer.ca/en/on/We-can-help/Minds-In-Motion

  1. Using a Personal Trainer

If you are looking for more one-on-one training, you can access a personal trainer who specializes in dementia. This is a great way to get specially tailored exercise programs that are perfect for you! Because these programs are tailored to you, the time spent exercising will give you the most bang for your buck. You will maintain your independence for longer, be able to get up off the toilet easily, walk to the grocery store, and so much more. Personal training can be offered in a facility or in the home, whatever is preferable to you. Looking for a personal trainer who specializes in dementia in the Waterloo-Wellington Region? Contact MemoryFit at 905-299-1206.

 

So take that magic pill, no matter which way you do it, so you can live independently, maintain your memory, language skills, judgement capabilities, and have fun with your family!

 

 

 

 

 

 

Who’s Caring for Mom? – Part 2

By Eleanor Pineau

Last week I wrote about an incredible PSW who truly takes pride in her work and shares her love with all she meets. Our interview covered topics such as: (1) how she came to be a PSW; (2) what the general work day of a PSW consists of; and (3) specific topics relating to dementia. In this part 2 of the article, we will discuss the topics relating to dementia.


 

And so the interview continues:

Tell me about the experiences you have with families who have a loved one with dementia.

“All families are different and unique.” Maryanne gave examples of the different types of families. Some families are always present, making sure their loved one ate, are dressed, engaged in activities, and so on. Some families even request staff to show the resident their photo when they go away. I think that this is interesting for 2 reasons. Why do they Familywant their loved one shown a photo of them? Is it because they don’t want them to forget who they are? Or is it because they want their loved one to know that they care and love them and will be back? Or maybe both.

There are also the families who complain. But Maryanne believes that most of the time, these families just have a different way or a difficult time expressing their love for someone. She does however admit that there are the complainers and whiners.

And then there are the families who do not come at all.

The emotions families experience when a loved one falls ill with dementia are numerous and often conflicting. But what’s interesting is that so many different emotions can cause the same reaction. For example, a family member might visit their loved one because they truly love the person; they may visit them due to a sense of duty; they may visit due to culture; they may visit them because they feel guilty; etc. Although these emotions differ, the person still visits. However, you may be able to imagine that the atmosphere of the visit might change depending on the driving emotion.

I then asked Maryanne more specifically about families and their understanding of dementia.

“Most families understand what’s going on with their loved one with dementia but they don’t accept it! They know it’s dementia, and that they’re losing this and that, but they come to you and ask ‘why is my mom doing this, or doing that?’”

So if families understand what’s going on, but aren’t willing to accept it, how can we help them?

“I think they need support in order to accept it. Unfortunately the PSWs don’t have the time to help the families.” Having access to quality information and support at every stage of the dementia journey is essential to the emotional, physical, psychological, and social health of family members and family caregivers. Families should know that “your mother is at this stage and she will progress to this level, and then that level; her functions will be this, and the care will be that. They just bring them there, with no education or support. They need someone with the expert knowledge and someone with the experience to help them through it”

So where do families access this information and support? Do they have to do everything on their own in such a stressful and overwhelming time? Are the services adequate? You tell me in the comments below.

My next question asked whether she had some tips for people who are caring for someone displaying a behavioural problem.

Immediately, Maryanne replied with:

“Trust your instincts, use unconventional ways of caring for the person, and use an open mind.”

Maryanne told me a story about a man who had a very dirty mouth and would ask for sex every time a female PSW would walk into the room.

“So I walk into his room to get him up and ready for the day and he asked me for sex. I said ‘we will have sex after we go to the bathroom.’ He said ‘really?!’ And I said ‘yes, I promise.’ He got right up and went to the bathroom. For everyone else, he would fight them and wouldn’t go to the bathroom. They would have to do everything for him in there. As soon as I promised him what he wanted, he did it all, and I didn’t even have to help him. It was great. After, he forgot about the sex.”

What is absolutely incredible about this story is the feedback from the daughter. She told Maryanne, with tears in her eyes, that this is the first time that a PSW has not complained about her dad.

So you can see, that when caring for someone who may not be acting in the most socially appropriate way, that it is crucial to trust your instincts, use unconventional ways of caring, and have an open mind. After all, it’s not about you. It’s about making sure the person you are caring for is safe, happy, and has the best quality of life possible.

Another story Maryanne shared with me was about a man and wife living in the same suite, but in different bedrooms. The man would always wander at night and this made the staff very anxious about his safety and wellbeing, as well as the safety and wellbeing of the other residents. Maryanne analyzed the situation. What were the usual arrangements for this man and woman before they came to the home? And then the most obvious solution came to her head, that oddly enough, couldn’t be seen by any of the other staff. They rearranged the suite, put both beds in the same room, and now they shared a room at night. He never wandered again. You see, what was happening, was the man would wake up in the night, see that his wife was not beside him, so he would get up and go searching for her because he wanted to make sure she was ok. Now when he wakes up, he sees that she is right there in the bed beside him.

Again, in people with dementia, you need to look at what’s normal?! What were their routines before the disease? The solutions then come very easy.

To conclude our interview, I asked Maryanne if there was anything else she’d like to tell me. She left me with one striking statement:

“We care for animals, but we don’t care about the elderly. What does that say about us?”

 

 

The Fastest Growing Career!

Have you ever heard of the word “Gerontology”? What about “Geriatrics”? “Pediatrics”? Most people have heard of “pediatrics” before – it’s the doctor who specializes in children. On the other hand, a geriatrician is a doctor who specializes in older adults. Now what is a gerontologist, and what is gerontology? Gerontology is a term most people are unfamiliar with. It is however a term that everyone should get to know – especially older adults. Gerontology is the scientific study of old age, its processes, and the problems faced by older adults relating to physical health, social wellbeing, mental health, and so forth. In lay terms, it’s the study of health and wellbeing in older adults. Gerontologists can be found in an array of institutions including health care, businesses, non-profits, and governments. As a Gerontologist, I study the health and wellbeing of older adults. I work in universities doiabout-gerontology-mng research, in the community and with non-profits. I devise ways to positively impact the lives of older adults. I accomplish this by using research that I, and others have done, which I then implement as programs to individuals, in the community, in facilities (like hospitals, retirement homes, assisted living facilities, and long-term care homes), and at the policy level.

With the aging of the population all across the world (aging population – this means that the median age of a population is increasing; in other words, more and more of our population is now composed of people 65 years and older than it is of persons who are 15 years and younger) the health of older adults is becoming more of a concern. Why is it becoming more of a concern you ask? A lot of media has termed this aging of the population as a gray tsunami that we are unable to cope with. But in fact, new research shows that it is possible to cope with this demographic shift. What is important to consider, is that older adults are the largest and most expensive consumer of health care. In Canada, because the government pays for healthcare through taxation, it is important to devise ways that we can prevent such high expenses. This is where gerontologists come in!

Gerontologists develop and implement strategies that improve and maintain the health of older adults. More importantly, they develop and implement strategies that improve the QUALITY OF LIFE of seniors. (I will talk about the work gerontologists do in an upcoming blog). By doing these things, visits to the doctor, the hospital, and residential moves to retirement homes or the dreaded nursing home, are delayed or prevented altogether!

Now I want to paint you a little picture. Think of a nursing home. What do you see? You see a little old lady sitting in her wheelchair, all alone, in her room. She’s very thin, you can see her blood vessels on her hands, and the light in her eyes has gone out. Now think of your mother, your grandmother, your father or grandfather. Imagine them in the place of this older woman. Living in a nursing home is a fate no person will EVER tell you they want. This picture is unfortunately not an uncommon scenario. As a gerontologist and as a human being, it is my aim to prevent this from happening. With the aging of the baby boom and the subsequent aging of the population, action needs to be taken to support and improve the health and quality of life of older adults. Gerontologists are the first line of action in this quest, and are here to make the lives of the senior population better. Remember, it is not just about the length of life lived, but the quality of life lived.

By Eleanor Pineau

February 24, 2016